Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns.

Foreign Body (FB) aspiration incidence follows a bimodal distribution and is commonly seen in children under the age of 5 or adults with advanced age. The type of FB can be organic or non-organic and varies depending on age, region of the world, and socioeconomic status. In children, FB aspiration is often a consequence of development and exploration. Aspiration of FB in adults typically occurs when cough reflex is blunted due to altered sensorium (from drugs, medications, advanced age), trauma to the airway, poor swallowing, or anatomical variations in the GI tract (strictures, Zenker’s Diverticulum, etc. Symptoms can range from cough to asphyxiation depending on the acuity of the aspiration event. Initial management is focused on ensuring there is no airway compromise leading to respiratory failure. Bronchoscopy is the treatment of choice to retrieve the FB. This chapter will review the incidence of FB aspiration in children vs. adults and will focus on diagnosis and treatment including bronchoscopy, role of ECMO, and surgical intervention.

Postmenopausal virilization and symptoms of hyperandrogenism can be attributed to tumorous or nontumorous causes. Androgen secreting tumors can arise from either the ovarian sex cord/stromal cells or from the adrenal glands. Cystadenomas are relatively benign ovarian epithelial tumors that have rarely been implicated as the cause of hyperandrogenism. Histologically these tumors are classified as mucinous or serous. We present here a case of a 60-year-old postmenopausal female with symptoms of hyperandrogenism including hirsutism and virilization for one year. Labs were significant for high total testosterone levels persistently. On imaging, our patient was found to have a left adnexal cyst, which was subsequently removed and found to be of serous histology. Upon removal of the cyst, patients' total testosterone levels normalized. Our case highlights the importance of including cystadenomas in the differentials when evaluating for tumorous causes of hyperandrogenism.

Ultrasound (US)-guided fine-needle aspiration (FNA) is a minimally invasive procedure that can be performed by an in-training pulmonologist. This is a retrospective study of 73 patients who underwent US-guided FNA by pulmonologist and interventional radiologist. Comparable diagnostic yield was found in this study (88.0% vs 81.3%, P = 0.460), but a higher number of second diagnostic procedures was seen in the Interventional Radiology group (22.9% vs 16.0%, P = 0.488). No significant complications were reported in the pulmonary group. In-training pulmonologists can safely perform US-guided FNA for thoracic and extrathoracic lesions.